Basic Information
Provider Information
NPI: 1376296004
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAHN
FirstName: RACHAEL
MiddleName: ELIZABETH
NamePrefix:  
NameSuffix:  
Credential: NP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3345 FILLMORE ST APT 104
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941232725
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 26 CALIFORNIA ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941114803
CountryCode: US
TelephoneNumber: 4157817077
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/02/2022
LastUpdateDate: 04/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/15/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X95020642CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
163W00000XRN297817GAN Nursing Service ProvidersRegistered Nurse 

No ID Information.


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